House approves caps on hospital markups for outpatient drugs after hours of debate

The House of Representatives on the morning calendar voted to concur in the senate proposal of amendment to House Bill 266, an act addressing hospital-administered outpatient prescription drug pricing under the federal 340B program, adopting a further amendment that sets temporary caps tying commercial charges to the federal average sales price (ASP).

Supporters framed the amendment as immediate consumer relief. The member from Winooski (Representative; name not specified), the bill reporter, said Vermonters currently "pay on average 600% more than the national average sales price for hospital administered drugs," and described a cited example in which a hospital-billed price for the cancer-support drug Neulasta was reduced in the speaker's telling from $95,000 to an ASP of $1,357. "That is price gouging," the member said.

The amendment adds a price cap (120% of ASP, with a transitional higher cap for the remainder of 2025 for some drugs) and a twice-yearly updating frequency for the ASP reference. It also prohibits cost shifting, allows hospitals to appeal to the Green Mountain Care Board (GMCB) if the cap demonstrably harms access or quality, and exempts certain non-network critical access hospitals.…